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1.
Artigo em Chinês | MEDLINE | ID: mdl-38973031

RESUMO

Objective:To evaluate the effects of cochlear implantation in patients with single-sided deafness(SSD) and asymmetrical hearing loss(AHL). Methods:Seventeen Mandarin-speaking CI patients diagnosed as SSD/AHL were recruited in our study. The Tinnitus Handicap Inventory(THI) and the Visual Analogue Scale(VAS) were used to assess changes in tinnitus distress and tinnitus loudness in SSD patients at each time point(pre-operation and post-operation). Results:The THI score and all 3 dimensions were significant decreased with CI-on than pre-operation(P<0.05). Tinnitus VAS scores were also decreased, and VAS scores were lower with CI-on than with CI-off, and were both significantly different at each time point after CI switch-on(P<0.05). Conclusion:CI could help SSD/AHL patients to suppress tinnitus and reduce the loudness of tinnitus. However, CI should not be a treatment of tinnitus.


Assuntos
Implante Coclear , Perda Auditiva Unilateral , Zumbido , Humanos , Implante Coclear/métodos , Feminino , Masculino , Pessoa de Meia-Idade , Adulto , Resultado do Tratamento , Implantes Cocleares , Idoso , Perda Auditiva
2.
Artigo em Chinês | MEDLINE | ID: mdl-38973049

RESUMO

Large vestibular aqueduct syndrome(LVAS) is a common recessive hereditary hearing loss disease, and some patients may also experience vestibular dysfunction. With the wide application of cochlear implant(CI) and the development of vestibular medicine, the pathophysiological mechanism of LVAS and the influence mechanism of CI on vestibular function are gradually elucidated. Consequently, the evaluation and rehabilitation of vestibular dysfunction function have also become research hotspots. This article reviews studies on vestibular function and related rehabilitation in patients with large vestibular aqueduct syndrome.


Assuntos
Aqueduto Vestibular , Humanos , Aqueduto Vestibular/anormalidades , Implantes Cocleares , Doenças Vestibulares/reabilitação , Doenças Vestibulares/fisiopatologia , Implante Coclear , Perda Auditiva Neurossensorial/reabilitação , Perda Auditiva Neurossensorial/fisiopatologia , Vestíbulo do Labirinto/fisiopatologia
3.
Artigo em Chinês | MEDLINE | ID: mdl-38973051

RESUMO

With the development of social economic and technology, Cochlear Implantation has became an effective therapy for patients who suffered from severe or profound hearing impairment. In the meantime, patients' demands for sound and auditory quality are also increasing. In terms of speech recognition, localization, and auditory quality, bilateral hearing is closer to the auditory experience of normal individuals, so bilateral cochlear implantation(BCI) emerged as the times require. In this article, we will introduce the status and progress of bimodal regarding to the following aspects: the brief history, the advantages of BCI, different methods for BCI, and the problems encountered in BCI.


Assuntos
Implante Coclear , Implantes Cocleares , Humanos , Implante Coclear/métodos , Percepção da Fala , Perda Auditiva/cirurgia
4.
J Vis Exp ; (208)2024 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-38975780

RESUMO

Measuring the electrically evoked stapedius reflex during the fitting of cochlear implants (CIs) provides a reliable estimation of maximum comfort levels, resulting in the programming of the CI with high hearing comfort and good speech understanding. Detection of the stapedius reflex and the required stimulation level on each implant channel is already being performed during surgery, whereby intraoperative stapedius reflexes are observed through the surgical microscope. Intraoperative stapedius reflex detection is both an indicator that the auditory nerve is responding to electrical stimulation up to the brainstem and a test for the ability to perform postoperative stapedius reflex measurements. Postoperative stapedius reflex thresholds can be used to estimate upper stimulation levels in the CI fitting process. In particular, in children or patients unable to provide feedback on loudness perception, this method avoids inadequate stimulation with the CI, which can result in poor hearing performance. In addition, overstimulation can be avoided, which could even lead to refusal to use the device.


Assuntos
Implante Coclear , Estimulação Elétrica , Estapédio , Humanos , Estapédio/fisiologia , Implante Coclear/métodos , Estimulação Elétrica/métodos , Implantes Cocleares , Reflexo Acústico/fisiologia
6.
PLoS One ; 19(7): e0306613, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38980854

RESUMO

Platinum and platinum-based alloys are used as the electrode material in cochlear implants because of the biocompatibility and the favorable electrochemical properties. Still, these implants can fail over time. The present study was conducted to shed light on the effects of microstructure on the electrochemical degradation of platinum. After three days of stimulation with a square wave signal, corrosive attack appeared on the platinum surface. The influence of mechanical deformation, in particular rolling, on the corrosion resistance of platinum was also prominent. The cyclic voltammetry showed a clear dependence on the electrolyte used, which was interpreted as an influence of the buffer in the artificial perilymph used. In addition, the polarization curves showed a shift with grain size that was not expected. This could be attributed to the defects present on the surface. These findings are crucial for the manufacture of cochlear implants to ensure their long-term functionality.


Assuntos
Implantes Cocleares , Platina , Platina/química , Teste de Materiais , Corrosão , Humanos , Ligas/química , Propriedades de Superfície , Materiais Biocompatíveis/química
7.
Artigo em Chinês | MEDLINE | ID: mdl-38965850

RESUMO

Objectives: To investigate the outcomes of cochlear implantation in Mandarin-speaking cochlear implant (CI) users with single-sided deafness (SSD). Methods: This study was a single-center prospective cohort study. Eleven Mandarin-speaking adult SSD patients who underwent CI implantation at Capital Medical University Beijing Tongren Hospital from August 2020 to October 2021 were recruited, including 6 males and 5 females, with the age ranging from 24 to 50 years old. In a sound field with 7 loudspeakers distributed at 180°, we measured root-mean-square error(RMSE)in SSD patients at the preoperative, 1-month, 3-month, 6-month, and 12-month after switch-on to assess the improvement of sound source localization. The Mandarin Speech Perception (MSP) was used in the sound field to test the speech reception threshold (SRT) of SSD patients under different signal-to-noise locations in a steady-state noise under conditions of CI off and CI on, to reflect the head shadow effect(SSSDNNH), binaural summation effect(S0N0) and squelch effect(S0NSSD). The Tinnitus Handicap Inventory (THI) and the Visual Analogue Scale (VAS) were used to assess changes in tinnitus severity and tinnitus loudness in SSD patients at each time point. The Speech, Spatial and Qualities of Hearing Scale(SSQ) and the Nijmegen Cochlear Implantation Scale (NCIQ) were used to assess the subjective benefits of spatial speech perception and quality of life in SSD patients after cochlear implantation. SPSS 19.0 software was used for statistical analysis. Results: SSD patients showed a significant improvement in the poorer ear in hearing thresholds with CI-on compared with CI-off; The ability to localize the sound source was significantly improved, with statistically significant differences in RMSE at each follow-up time compared with the preoperative period (P<0.05). In the SSSDNNH condition, which reflects the head shadow effect, the SRT in binaural hearing was significantly improved by 6.5 dB compared with unaided condition, and the difference was statistically significant (t=6.25, P=0.001). However, there was no significant improvement in SRT between the binaural hearing condition and unaided conditions in the S0N0 and S0NSSD conditions (P>0.05). The total score of THI and three dimensions were significant decreased (P<0.05). Tinnitus VAS scores were significantly lower in binaural hearing compared to the unaided condition (P<0.001). The total score of SSQ, and the scores of speech and spatial dimensions were significant improved in binaural hearing compared to the unaided condition (P<0.001). There was no statistical difference in NCIQ questionnaire scores between preoperative and postoperative (P>0.05), and only the self-efficacy subscore showed a significant increase(Z=-2.497,P=0.013). Conclusion: CI could help Mandarin-speaking SSD patients restore binaural hearing to some extent, improve sound localization and speech recognition in noise. In addition, CI in SSD patients could suppress tinnitus, reduce the loudness of tinnitus, and improve subjective perceptions of spatial hearing and quality of life.


Assuntos
Implante Coclear , Humanos , Masculino , Feminino , Implante Coclear/métodos , Adulto , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do Tratamento , Perda Auditiva Unilateral/cirurgia , Implantes Cocleares , Percepção da Fala , Adulto Jovem , Localização de Som , Zumbido/cirurgia , Surdez/cirurgia , Auxiliares de Audição
9.
BMC Med Imaging ; 24(1): 145, 2024 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-38872126

RESUMO

BACKGROUND: To compare the diagnostic value of 120-kV with conventional 96-kV Cone-Beam CT (CBCT) of the temporal bone after cochlear implant (CI) surgery. METHODS: This retrospective study included CBCT scans after CI surgery between 06/17 and 01/18. CBCT allowed examinations with 96-kV or 120-kV; other parameters were the same. Two radiologists independently evaluated following criteria on 5-point Likert scales: osseous spiral lamina, inner and outer cochlear wall, semi-circular canals, mastoid trabecular structure, overall image quality, metal and motion artefacts, depiction of intracochlear electrode position and visualisation of single electrode contacts. Effective radiation dose was assessed. RESULTS: Seventy-five patients (females, n = 39 [52.0%], mean age, 55.8 ± 16.5 years) were scanned with 96-kV (n = 32, 42.7%) and 120-kV (n = 43, 57.3%) protocols including CI models from three vendors (vendor A n = 7; vendor B n = 43; vendor C n = 25). Overall image quality, depiction of anatomical structures, and electrode position were rated significantly better in 120-kV images compared to 96-kV (all p < = 0.018). Anatomical structures and electrode position were rated significantly better in 120-kV CBCT for CI models from vendor A and C, while 120-kV did not provide improved image quality in CI models from vendor B. Radiation doses were significantly higher for 120-kV scans compared to 96-kV (0.15 vs. 0.08 mSv, p < 0.001). CONCLUSIONS: 120-kV and 96-kV CBCT provide good diagnostic images for the postoperative CI evaluation. While 120-kV showed improved depiction of temporal bone and CI electrode position compared to 96-kV in most CI models, the 120-kV protocol should be chosen wisely due to a substantially higher radiation exposure.


Assuntos
Implantes Cocleares , Tomografia Computadorizada de Feixe Cônico , Doses de Radiação , Osso Temporal , Humanos , Tomografia Computadorizada de Feixe Cônico/métodos , Masculino , Pessoa de Meia-Idade , Feminino , Estudos Retrospectivos , Osso Temporal/diagnóstico por imagem , Idoso , Adulto , Implante Coclear/métodos
10.
Trends Hear ; 28: 23312165241261480, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38887094

RESUMO

This multi-center study examined the safety and effectiveness of cochlear implantation of children between 9 and 11 months of age. The intended impact was to support practice regarding candidacy assessment and prognostic counseling of pediatric cochlear implant candidates. Data in the clinical chart of children implanted at 9-11 months of age with Cochlear Ltd devices at five cochlear implant centers in the United States and Canada were included in analyses. The study included data from two cohorts implanted with one or two Nucleus devices during the periods of January 1, 2012-December 31, 2017 (Cohort 1, n = 83) or between January 1, 2018 and May 15, 2020 (Cohort 2, n = 50). Major adverse events (requiring another procedure/hospitalization) and minor adverse events (managed with medication alone or underwent an expected course of treatment that did not require surgery or hospitalization) out to 2 years post-implant were monitored and outcomes measured by audiometric thresholds and parent-reports on the IT-MAIS and LittlEARS questionnaires were collected. Results revealed 60 adverse events in 41 children and 227 ears implanted (26%) of which 14 major events occurred in 11 children; all were transitory and resolved. Improved hearing with cochlear implant use was shown in all outcome measures. Findings reveal that the procedure is safe for infants and that they show clear benefits of cochlear implantation including increased audibility and hearing development.


Assuntos
Implante Coclear , Implantes Cocleares , Humanos , Lactente , Implante Coclear/instrumentação , Implante Coclear/efeitos adversos , Masculino , Feminino , Implantes Cocleares/efeitos adversos , Resultado do Tratamento , Canadá , Estados Unidos , Fatores de Tempo , Estudos Retrospectivos , Limiar Auditivo , Complicações Pós-Operatórias
11.
J Otolaryngol Head Neck Surg ; 53: 19160216241250351, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38888946

RESUMO

OBJECTIVE: The long-term preservation of residual hearing after cochlear implantation has become a major goal over the past few years. The aim of the present study was to evaluate residual hearing in the long-term follow-up using mid-scala electrodes. METHODS: In this retrospective, single-center study, we collected data from 27 patients who were implanted between 2014 and 2015 with residual hearing in the low-frequency range using a mid-scala electrode. Measurements of the hearing thresholds were carried out directly postoperatively (day 1 after surgery) and in the long-term follow-up 43.7 ± 6.9 months. The calculation of the extent of audiological hearing preservation was determined using the HEARRING group formula by Skarsynski. RESULTS: Postoperative preservation of residual hearing was achieved in 69.2% of the cases in the low-frequency range between 250 Hz and 1 kHz, of which 89.5% of the patients had frequencies that suggested using electroacoustic stimulation (EAS). In the long-term follow-up, 30.8% of the patients showed residual hearing; however, 57.1% had apparently benefited from EAS. CONCLUSION: Preservation of residual hearing is feasible in the long term using mid-scala electrodes. Postoperatively, there is over the half of patients who benefit from an EAS strategy. The long-term follow-up shows a certain decrease in residual hearing. However, these results are comparable to studies relating to other types of electrodes. Further research should be conducted in future to better evaluate hearing loss in long-term follow-up, compared to direct postoperative audiological results.


Assuntos
Implante Coclear , Implantes Cocleares , Humanos , Estudos Retrospectivos , Masculino , Feminino , Implante Coclear/métodos , Pessoa de Meia-Idade , Adulto , Seguimentos , Audição/fisiologia , Idoso , Limiar Auditivo , Adolescente , Pré-Escolar , Resultado do Tratamento , Criança , Eletrodos Implantados , Adulto Jovem , Desenho de Prótese , Perda Auditiva/cirurgia , Fatores de Tempo
12.
PLoS One ; 19(6): e0302790, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38885210

RESUMO

Cochlear implantation is an effective intervention to restore useful aspects of hearing function in adults with severe-to-profound hearing loss. Tinnitus, the perception of sound in the absence of an external source, is common in people with severe-to-profound hearing loss. Existing evidence suggests cochlear implantation may be effective in reducing the negative impact of tinnitus in this population. However, this is contradicted by data suggesting that up to half of cochlear implant recipients experience tinnitus, and that some of these patients who did not have tinnitus before cochlear implantation experience it after surgery or cochlear implant activation. Most evidence on the effects of cochlear implantation on tinnitus comes from secondary data in cochlear implant studies primarily concerned with hearing-related outcomes. Hence, the quality of the evidence for effects on tinnitus is low and not suitable to inform clinical recommendations or decision-making. This study will systematically collect data on tinnitus and tinnitus-related outcomes from patients at multiple points during the cochlear implant pathway to characterise changes in tinnitus. This will improve our understanding of the effects of cochlear implantation for tinnitus in adults with severe to profound hearing loss and inform the design of clinical trials of cochlear implantation for tinnitus.


Assuntos
Implante Coclear , Zumbido , Zumbido/cirurgia , Zumbido/etiologia , Humanos , Implante Coclear/métodos , Estudos Prospectivos , Implantes Cocleares , Adulto , Resultado do Tratamento , Perda Auditiva/cirurgia , Masculino , Feminino
13.
J Acoust Soc Am ; 155(6): 3833-3847, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38884525

RESUMO

For cochlear implant (CI) listeners, holding a conversation in noisy and reverberant environments is often challenging. Deep-learning algorithms can potentially mitigate these difficulties by enhancing speech in everyday listening environments. This study compared several deep-learning algorithms with access to one, two unilateral, or six bilateral microphones that were trained to recover speech signals by jointly removing noise and reverberation. The noisy-reverberant speech and an ideal noise reduction algorithm served as lower and upper references, respectively. Objective signal metrics were compared with results from two listening tests, including 15 typical hearing listeners with CI simulations and 12 CI listeners. Large and statistically significant improvements in speech reception thresholds of 7.4 and 10.3 dB were found for the multi-microphone algorithms. For the single-microphone algorithm, there was an improvement of 2.3 dB but only for the CI listener group. The objective signal metrics correctly predicted the rank order of results for CI listeners, and there was an overall agreement for most effects and variances between results for CI simulations and CI listeners. These algorithms hold promise to improve speech intelligibility for CI listeners in environments with noise and reverberation and benefit from a boost in performance when using features extracted from multiple microphones.


Assuntos
Implantes Cocleares , Aprendizado Profundo , Ruído , Inteligibilidade da Fala , Percepção da Fala , Humanos , Ruído/efeitos adversos , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Idoso , Algoritmos , Adulto Jovem , Implante Coclear/instrumentação
14.
Acta Otolaryngol ; 144(3): 181-186, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38824490

RESUMO

BACKGROUND: Follow-up of cochlear implant effectiveness is mainly focused on 3 years postoperatively, and studies with more than 5 years of observation are rare, especially for local Chinese brands. OBJECTIVES: Nurotron (Chinese domestic cochlear implant brand) CI recipients who participated in the clinical trial in 2009 were followed-up for 10 years prospectively, providing data to guide doctors and patients. MATERIAL AND METHODS: From December 2009 to April 2010, 57 subjects underwent Nurotron Venus CI surgery at multiple-centers, and were continued to be followed up and assessed at 1, 2, 3, 4, 5, and 10 years after switch on. RESULTS: All recipients were successfully implanted with CIs with no difficulty in subsequent use with one reported case of re-implantation at 9 years after implantation. The aided hearing thresholds were significantly improved at one month after switch on (p < 0.0001) and remained stable afterwards for 10 years. Speech recognition scores were significantly higher than pre-operative results (p < 0.05) and continued to improve till 3 years after switch on. At 10 years post-operation, most subjects had improved QOL scores in most sub-items. CONCLUSIONS AND SIGNIFICANCE: Nurotron Venus CI System provides long-term, stable results in hearing speech assistance capabilities and can improve the quality of life of CI recipients.


Assuntos
Implantes Cocleares , Humanos , Seguimentos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , China , Qualidade de Vida , Adulto Jovem , Implante Coclear , Perda Auditiva/cirurgia , Estudos Prospectivos , Adolescente , Idoso , Criança , Percepção da Fala , População do Leste Asiático
15.
Sensors (Basel) ; 24(11)2024 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-38894099

RESUMO

Cochlear implants are crucial for addressing severe-to-profound hearing loss, with the success of the procedure requiring careful electrode placement. This scoping review synthesizes the findings from 125 studies examining the factors influencing insertion forces (IFs) and intracochlear pressure (IP), which are crucial for optimizing implantation techniques and enhancing patient outcomes. The review highlights the impact of variables, including insertion depth, speed, and the use of robotic assistance on IFs and IP. Results indicate that higher insertion speeds generally increase IFs and IP in artificial models, a pattern not consistently observed in cadaveric studies due to variations in methodology and sample size. The study also explores the observed minimal impact of robotic assistance on reducing IFs compared to manual methods. Importantly, this review underscores the need for a standardized approach in cochlear implant research to address inconsistencies and improve clinical practices aimed at preserving hearing during implantation.


Assuntos
Implante Coclear , Implantes Cocleares , Humanos , Implante Coclear/métodos , Pressão , Cóclea/cirurgia , Cóclea/fisiologia , Procedimentos Cirúrgicos Robóticos/métodos , Robótica/métodos , Perda Auditiva/cirurgia , Perda Auditiva/fisiopatologia
16.
Sci Rep ; 14(1): 14094, 2024 06 18.
Artigo em Inglês | MEDLINE | ID: mdl-38890428

RESUMO

While the relationships between spectral resolution, temporal resolution, and speech recognition are well defined in adults with cochlear implants (CIs), they are not well defined for prelingually deafened children with CIs, for whom language development is ongoing. This cross-sectional study aimed to better characterize these relationships in a large cohort of prelingually deafened children with CIs (N = 47; mean age = 8.33 years) by comprehensively measuring spectral resolution thresholds (measured via spectral modulation detection), temporal resolution thresholds (measured via sinusoidal amplitude modulation detection), and speech recognition (measured via monosyllabic word recognition, vowel recognition, and sentence recognition in noise via both fixed signal-to-noise ratio (SNR) and adaptively varied SNR). Results indicated that neither spectral or temporal resolution were significantly correlated with speech recognition in quiet or noise for children with CIs. Both age and CI experience had a moderate effect on spectral resolution, with significant effects for spectral modulation detection at a modulation rate of 0.5 cyc/oct, suggesting spectral resolution may improve with maturation. Thus, it is possible we may see an emerging relationship between spectral resolution and speech perception over time for children with CIs. While further investigation into this relationship is warranted, these findings demonstrate the need for new investigations to uncover ways of improving spectral resolution for children with CIs.


Assuntos
Implantes Cocleares , Surdez , Percepção da Fala , Humanos , Percepção da Fala/fisiologia , Criança , Masculino , Feminino , Estudos Transversais , Surdez/fisiopatologia , Pré-Escolar , Razão Sinal-Ruído , Ruído , Adolescente
17.
Sci Rep ; 14(1): 12787, 2024 06 04.
Artigo em Inglês | MEDLINE | ID: mdl-38834775

RESUMO

Cochlear implant users experience difficulties controlling their vocalizations compared to normal hearing peers. However, less is known about their voice quality. The primary aim of the present study was to determine if cochlear implant users' voice quality would be categorized as dysphonic by the Acoustic Voice Quality Index (AVQI) and smoothed cepstral peak prominence (CPPS). A secondary aim was to determine if vocal quality is further impacted when using bilateral implants compared to using only one implant. The final aim was to determine how residual hearing impacts voice quality. Twenty-seven cochlear implant users participated in the present study and were recorded while sustaining a vowel and while reading a standardized passage. These recordings were analyzed to calculate the AVQI and CPPS. The results indicate that CI users' voice quality was detrimentally affected by using their CI, raising to the level of a dysphonic voice. Specifically, when using their CI, mean AVQI scores were 4.0 and mean CPPS values were 11.4 dB, which indicates dysphonia. There were no significant differences in voice quality when comparing participants with bilateral implants to those with one implant. Finally, for participants with residual hearing, as hearing thresholds worsened, the likelihood of a dysphonic voice decreased.


Assuntos
Implantes Cocleares , Qualidade da Voz , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Adulto , Disfonia/fisiopatologia , Acústica da Fala , Implante Coclear
18.
Eur Arch Otorhinolaryngol ; 281(7): 3839-3843, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38825603

RESUMO

PURPOSE: The aim of the study is to capture the difference between the groups in direct relation to the type of electrode array insertion during cochlear implantation (CI). The robotic insertion is expected to be a more gently option. As recent studies have shown, there is a difference in perception of visual vertical (SVV) and postural control related to the CI. We assume that there can be differences in postural control and space perception outcomes depending on the type of the surgical method. METHODS: In total, 37 (24 females, mean age ± SD was 42.9 ± 13.0) candidates for CI underwent an assessment. In 14 cases, the insertion of the electrode array was performed by a robotic system (RobOtol, Colin, France) and 23 were performed conventionally. In all of these patients, we performed the same examination before the surgery, the first day, and 3 weeks after the surgery. The protocol consists of static posturography and perception of visual vertical. RESULTS: The both groups, RobOtol and conventional, responded to the procedure similarly despite the dissimilar electrode insertion. There was no difference between two groups in the dynamic of perception SVV and postural parameters. Patients in both groups were statistically significantly affected by the surgical procedure, SVV deviation appeared in the opposite direction from the implanted ear: 0.90° ± 1.25; - 1.67° ± 3.05 and - 0.19° ± 1.78 PRE and POST surgery (p < 0.001). And this deviation was spontaneously adjusted in FOLLOW-UP after 3 weeks (p < 0.01) in the both groups. We did not find a significant difference in postural parameters between the RobOtol and conventional group, even over time. CONCLUSION: Although the robotic system RobOtol allows a substantial reduction in the speed of insertion of the electrode array into the inner ear, our data did not demonstrate a postoperative effect on vestibular functions (SVV and posturography), which have the same character and dynamics as in the group with standard manual insertion. REGISTRATION NUMBER: The project is registered on clinicaltrials.gov (registration number: NCT05547113).


Assuntos
Implante Coclear , Equilíbrio Postural , Procedimentos Cirúrgicos Robóticos , Percepção Espacial , Humanos , Feminino , Implante Coclear/métodos , Masculino , Adulto , Procedimentos Cirúrgicos Robóticos/métodos , Pessoa de Meia-Idade , Percepção Espacial/fisiologia , Equilíbrio Postural/fisiologia , Resultado do Tratamento , Implantes Cocleares
19.
Codas ; 36(4): e20230220, 2024.
Artigo em Português, Inglês | MEDLINE | ID: mdl-38922246

RESUMO

PURPOSE: To analyze the performance of auditory speech perception (PF) after cochlear implant (CI) replacement surgery and associations with age, times of use of the first CI, deprivation, recovery and use of the second device. METHODS: The retrospective study analyzed the medical records of 68 participants reimplanted from 1990 to 2016, and evaluated with PF performance tests, considering as a reference, the greater auditory capacity identified during the use of the first CI. Also analyzed were: Etiology of hearing loss; the reasons for the reimplantation; device brands; age range; sex; affected ear; age at first implant; time of use of the first CI, deprivation, recovery and use of the second device. The analyzes followed with the Chi-Square and Spearman, Mann-Whitney and Kruskal-Wallis tests (CI=95%; p≤0.05; Software SPSS®.v22). RESULTS: Most were children with hearing loss due to idiopathic causes and meningitis. Abrupt stoppage of operation was the most common cause for device replacement. Most cases recovered and maintained or continued to progress in PF after reimplantation. Adults have the worst recovery capacity when compared to children and adolescents. The PF capacity showed a significant association (p≤0.05) with: age at first implant; time of use of the first and second CI. CONCLUSION: Periodic programming and replacement of the device when indicated are fundamental for the maintenance of auditory functions. Being young and having longer use of implants represent advantages for the development of speech perception skills.


OBJETIVO: Analisar o desempenho da percepção auditiva da fala (PF) após cirurgia de substituição do implante coclear (IC) e identificar associações com a idade, tempos de uso dos dispositivos, privação e recuperação. MÉTODO: O estudo retrospectivo analisou os prontuários de 1990 a 2016 e considerou como referência o maior escore da capacidade auditiva identificada ao longo do uso do primeiro IC. Foram coletados dados epidemiológicos; etiologia; causas da substituição e marca dos dispositivos; classificação etária; idades no primeiro e segundo implante; tempos de utilização, privação e de recuperação da capacidade auditiva. Os dados foram avaliados por meio de testes estatísticos não paramétricos (IC=95%; p<0.05). RESULTADOS: Foram avaliados 68 participantes (31 adultos e 37 crianças), sendo 52,9% do sexo feminino e as principais etiologias da perda auditiva foram: idiopática (48,5%), infecciosa (33,8%) e outras causas não infecciosas (17,6%). A idade média verificada na implantação do primeiro e do segundo IC, foram: 102±143,4 e 178,9±173,4 meses. Os tempos médios de uso do primeiro IC, privação, recuperação e uso do segundo IC, foram respectivamente: (76,1±63,3); (2,8±2,4); (6,5±7,1); (75,6±48,3) meses. A substituição foi motivada principalmente pela parada abrupta de funcionamento (77,9%) e 85,3% dos participantes recuperaram a PF, que esteve significativamente associada à idade no primeiro IC, e os tempos de utilização dos dispositivos (p<0.05). CONCLUSÃO: A maior parte dos indivíduos submetidos ao reimplante conseguem recuperar e/ou continuar o desenvolvimento das habilidades auditivas. A idade mais jovem e o tempo de uso dos dispositivos são fatores que influenciam na capacidade de recuperação da PF em reimplantados.


Assuntos
Implante Coclear , Implantes Cocleares , Percepção da Fala , Humanos , Percepção da Fala/fisiologia , Estudos Retrospectivos , Feminino , Criança , Masculino , Adolescente , Adulto , Pré-Escolar , Adulto Jovem , Pessoa de Meia-Idade , Perda Auditiva/cirurgia , Perda Auditiva/reabilitação , Lactente , Idoso , Fatores Etários , Reimplante
20.
Otol Neurotol ; 45(6): 627-634, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38865719

RESUMO

OBJECTIVE: To compare the rate of device failure for those cochlear implants (CIs) involved in the 2020 Food and Drug Administration (FDA) voluntary field corrective action (VFCA). DATABASES REVIEWED: Medline, Embase, and Scopus. METHODS: A systematic review was performed according to the PRISMA guidelines. Publications reporting institutional experiences with implants affected by the VFCA were included. Outcomes assessed included etiology of, rate of, and time to failure and pre-/post-device failure speech perception testing. All outcomes reported in at least two independent studies were included in a meta-analysis. RESULTS: Six studies met criteria for analysis. The overall pooled failure rate was 23.7% (95% CI, 11.6-38.4%). The pooled device, inconclusive, and medical failure rates were 21.5%, 0.2%, and 0.7%, respectively. Pediatric failure rates were higher than those of adults (46.9% [95% CI, 11.2-84.5%] versus 32.6% [95% CI, 8.2-63.7%]). WRS declined with primary implant failure (55.1% [95% CI, 48.0-62.1%] to 34.1% [95% CI, 30.2-38.0%]) but improved after reimplantation (34.1% [95% CI, 30.2-38.0%] to 50.1% [95% CI, 45.2-55.1%]). CONCLUSIONS: The rate of pooled reported failure for CIs falling under the 2020 VFCA in the literature thus far is 23.7%. The overwhelming majority of these failures were device related, the rates of which were higher in children. Speech perception improved significantly after reimplantation.


Assuntos
Implantes Cocleares , Falha de Prótese , United States Food and Drug Administration , Humanos , Estados Unidos , Implante Coclear , Percepção da Fala/fisiologia
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